Comparison of Risk Factor Profiles in Incidental Lewy Body Disease and Parkinson Disease

Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55902, USA.
Archives of neurology (Impact Factor: 7.42). 09/2009; 66(9):1114-9. DOI: 10.1001/archneurol.2009.170
Source: PubMed


To explore whether associations of potential risk factors for incidental Lewy body disease (iLBD) are similar to those for Parkinson disease (PD).
Brain autopsy study (1988-2004) of subjects without evidence of neurodegenerative disease or tremor who were evaluated by at least 1 physician within 1 year of death. Researchers analyzed incidental Lewy pathology blinded to clinical abstraction.
Olmsted County, Minnesota. Subjects Residents of Olmsted County and the immediate vicinity aged older than 60 years.
Whether risk factors previously associated with PD in Olmsted County are also associated with iLBD.
Of 235 subjects, 34 had iLBD (14.5%). The overall risk factor profiles for iLBD and PD were fairly similar between the 2 sets of odds ratio (OR) estimates, with 11 of 16 ORs in the same direction. Prior Olmsted County studies documented 7 risk factors with statistically significant associations with PD; for physician occupation and caffeine intake, the ORs for iLBD were in the same direction and statistically significant, whereas for education, head injury, and number of children, they were in the same direction but not significant; they were in the opposite direction but not statistically significant for depression and anxiety. Incidental Lewy body disease was not associated with various end-of-life conditions or causes of death, though these patients were slightly older and more likely cachectic.
Based on this exploratory study, iLBD and PD appear to have similar risk factor profiles. Thus, at least some cases of iLBD could represent preclinical PD, arrested PD, or a partial syndrome due to a lesser burden of causative factors. Incidental Lewy body disease is not explained by nonspecific end-of-life brain insults.

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Available from: Hiroshige Fujishiro
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    • "We have reported that ILBD cases in our brain bank do not have parkinsonian signs, other movement problems, or cognitive findings that are out of proportion to similarly assessed age-matched cases without Lewy bodies at autopsy (Frigerio et al., 2009). Both olfactory dysfunction and constipation have been reported to be associated with ILBD (Abbott et al., 2001; Ross et al., 2006). "
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    ABSTRACT: Evaluate electrophysiologic findings in incidental Lewy body disease (ILBD). ILBD, Control, and Parkinson's disease (PD) subjects had electrophysiological evaluation within 2 years prior to autopsy. Data analyzed included surface electromyography (EMG) of upper extremity muscles during rest and muscle activation, and electroencephalography (EEG) recording at rest. For EMG, gross tracings and spectral peaks were analyzed. EEG measures analyzed were background frequency and power in delta, theta, alpha, and beta bands. Three of ten ILBD subjects (30%) showed unilateral rhythmic EMG discharges at rest without a visually apparent rest tremor. The ILBD resting EMG frequency was lower than in the Control group with no overlap (P=.03) and close to that of the PD group. The ILBD group had significantly lower background rhythm frequency than the Control group (P=.001) but was greater than the PD group (P=.01). The electrophysiologic changes in ILBD cases are between those of Control and PD, suggesting that these findings may reflect changes correlating with ILBD as a possible precursor to PD. Electrophysiologic changes in ILBD may assist with the identification of a preclinical stage for Lewy body disorders and help the development of a therapeutic agent for modifying Lewy body disease progression.
    Full-text · Article · May 2011 · Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology
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    • "Cases with Lewy pathology in the brain stem without clinical evidence of parkinsonism are considered premotor PD or incidental LBD [1, 2]. Risk factor profiles in incidental LBD and PD are similar thus further supporting the idea that iLBD represents preclinical PD, arrested PD or a partial syndrome [51]. "
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